S T A T E O F N E W Y O R K
________________________________________________________________________
6377--A
2025-2026 Regular Sessions
I N S E N A T E
March 12, 2025
___________
Introduced by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and
when printed to be committed to the Committee on Health -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the social services law, in relation to requiring Medi-
caid to cover gender-affirming care regardless of federal funding; to
amend the executive law, in relation to prohibiting discriminatory
practices by health care entities; and to amend the insurance law, in
relation to prohibiting discriminatory practices by insurers and to
coverage for treatment for gender dysphoria or gender incongruence
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subdivision 2 of section 365-a of the social services law
is amended by adding a new paragraph (oo) to read as follows:
(OO) ALL MEDICALLY NECESSARY GENDER-AFFIRMING CARE REGARDLESS OF
WHETHER ANY FEDERAL FUNDS ARE AVAILABLE FOR SUCH COVERAGE.
§ 2. The executive law is amended by adding a new section 296-e to
read as follows:
§ 296-E. UNLAWFUL DISCRIMINATORY PRACTICES IN RELATION TO HEALTH CARE.
1. FOR THE PURPOSES OF THIS SECTION, THE TERM "HEALTH CARE ENTITY"
MEANS:
(A) A HOSPITAL OR PROVIDER AS DEFINED BY SECTION TWENTY-EIGHT HUNDRED
ONE OF THE PUBLIC HEALTH LAW; INCLUDING THOSE DEFINED IN SECTION TWO
HUNDRED NINETY-TWO OF THIS ARTICLE; OR
(B) A PROFESSIONAL LICENSED UNDER ARTICLE ONE HUNDRED THIRTY-ONE, ONE
HUNDRED THIRTY-ONE-B, ONE HUNDRED THIRTY-ONE-C, ONE HUNDRED THIRTY-TWO,
ONE HUNDRED THIRTY-THREE, ONE HUNDRED THIRTY-FOUR, ONE HUNDRED THIRTY-
SIX, ONE HUNDRED THIRTY-SEVEN, ONE HUNDRED THIRTY-SEVEN-A, ONE HUNDRED
THIRTY-NINE, ONE HUNDRED FORTY, ONE HUNDRED FORTY-ONE, ONE HUNDRED
FORTY-THREE, ONE HUNDRED FORTY-FOUR, ONE HUNDRED FIFTY-THREE, ONE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09201-08-5
S. 6377--A 2
HUNDRED FIFTY-SEVEN, ONE HUNDRED SIXTY-THREE, ONE HUNDRED SIXTY-FOUR, OR
ONE HUNDRED SIXTY-SEVEN OF THE EDUCATION LAW; OR
(C) AN ISSUER OR PROVIDER OF COVERAGE FOR HEALTH INSURANCE, AS DEFINED
BY SECTION SEVEN THOUSAND SEVEN HUNDRED FIVE OF THE INSURANCE LAW.
2. IT SHALL BE AN UNLAWFUL DISCRIMINATORY PRACTICE FOR ANY HEALTH CARE
ENTITY TO REFUSE SERVICES OR TO OTHERWISE DISCRIMINATE AGAINST ANY
PERSON ON THE BASIS OF SUCH PERSON'S AGE, RACE, CREED, COLOR, NATIONAL
ORIGIN, CITIZENSHIP OR IMMIGRATION STATUS, SEXUAL ORIENTATION, GENDER
IDENTITY OR EXPRESSION, MILITARY STATUS, SEX, DISABILITY, PREDISPOSING
GENETIC CHARACTERISTICS, FAMILIAL STATUS, MARITAL STATUS, OR STATUS AS A
VICTIM OF DOMESTIC VIOLENCE.
§ 3. The section heading and the opening paragraph and paragraphs 4, 7
and 8 of subsection (a) of section 3243 of the insurance law, as added
by section 2 of subpart D of part J of chapter 57 of the laws of 2019,
are amended and four new paragraphs 9, 10, 11 and 12 are added to read
as follows:
Discrimination because of RACE, NATIONAL ORIGIN, AGE, DISABILITY, sex
or marital status in hospital, surgical or medical expense insurance.
With regard to an accident and health insurance policy that provides
hospital, surgical, or medical expense coverage or a policy of student
accident and health insurance, as defined in subsection (a) of section
three thousand two hundred forty of this article, delivered or issued
for delivery in this state, no insurer shall because of RACE, COLOR,
CREED, NATIONAL ORIGIN, sex, marital status, DISABILITY, PREEXISTING
CONDITION, or based on pregnancy, false pregnancy, termination of preg-
nancy, or recovery therefrom, childbirth or related medical conditions:
(4) insert in the policy any condition, or make any stipulation,
whereby the insured binds [his or herself] THEMSELVES, or [his or her]
SUCH INSURED'S heirs, executors, administrators or assigns, to accept
any sum or service less than the full value or amount of such policy in
case of a claim thereon except such conditions and stipulations as are
imposed upon others in similar cases; and any such stipulation or condi-
tion so made or inserted shall be void;
(7) fix any lower rate or discriminate in the fees or commissions of
insurance agents or insurance brokers for writing or renewing such a
policy; [or]
(8) engage in sexual stereotyping[.];
(9) INCLUDE A POLICY CLAUSE THAT PURPORTS TO DENY, LIMIT, OR EXCLUDE
COVERAGE BASED ON AN INSURED'S SEXUAL ORIENTATION, GENDER IDENTITY OR
EXPRESSION, OR TRANSGENDER STATUS;
(10) DENY, LIMIT, OR OTHERWISE EXCLUDE MEDICALLY NECESSARY SERVICES OR
TREATMENT OTHERWISE COVERED BY A POLICY ON THE BASIS THAT THE TREATMENT
IS FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE; PROVIDED FURTHER THAT AN
INSURER SHALL PROVIDE AN INSURED WITH THE UTILIZATION REVIEW APPEAL
RIGHTS REQUIRED BY INSURANCE LAW AND PUBLIC HEALTH LAW ARTICLES 49 FOR
GENDER DYSPHORIA OR GENDER INCONGRUENCE TREATMENT THAT IS DENIED BASED
ON MEDICAL NECESSITY;
(11) DESIGNATE AN INSURED'S SEXUAL ORIENTATION, GENDER IDENTITY OR
EXPRESSION, OR TRANSGENDER STATUS AS A PRE-EXISTING CONDITION FOR THE
PURPOSE OF DENYING, LIMITING, OR EXCLUDING COVERAGE; OR
(12) DENY A CLAIM FROM AN INSURED OF ONE GENDER OR SEX FOR A SERVICE
THAT IS TYPICALLY OR EXCLUSIVELY PROVIDED TO AN INDIVIDUAL OF ANOTHER
GENDER OR SEX UNLESS THE INSURER HAS TAKEN REASONABLE STEPS, INCLUDING
REQUESTING ADDITIONAL INFORMATION, TO DETERMINE WHETHER THE INSURED IS
ELIGIBLE FOR THE SERVICES PRIOR TO DENIAL OF SUCH CLAIM.
S. 6377--A 3
§ 4. Section 4303 of the insurance law is amended by adding a new
subsection (ww) to read as follows:
(WW)(1) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, OR MEDICAL
COVERAGE SHALL PROVIDE MEDICALLY NECESSARY SERVICES OR TREATMENT OTHER-
WISE COVERED BY A POLICY ON THE BASIS THAT THE TREATMENT IS FOR GENDER
DYSPHORIA OR GENDER INCONGRUENCE.
(2) COVERAGE FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE SHALL NOT BE
SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE, INCLUDING CO-PAYMENTS,
UNLESS THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN SECTION
223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, IN WHICH CASE COVERAGE
FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE MAY BE SUBJECT TO THE PLAN'S
ANNUAL DEDUCTIBLE.
§ 5. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 24 to read as follows:
(24) (A) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, OR MEDICAL
COVERAGE SHALL ALSO PROVIDE COVERAGE FOR MEDICALLY NECESSARY SERVICES OR
TREATMENTS FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE THAT ARE OTHER-
WISE COVERED BY THE POLICY.
(B) COVERAGE FOR THE TREATMENT OF GENDER DYSPHORIA OR GENDER INCONGRU-
ENCE SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE, INCLUD-
ING CO-PAYMENTS, UNLESS THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS
DEFINED IN SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, IN
WHICH CASE COVERAGE FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE MAY BE
SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE.
§ 6. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 41 to read as follows:
(41)(A) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, OR MEDICAL
COVERAGE SHALL ALSO PROVIDE COVERAGE FOR MEDICALLY NECESSARY SERVICES OR
TREATMENTS FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE THAT ARE OTHER-
WISE COVERED BY THE POLICY.
(B) COVERAGE FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE SHALL NOT BE
SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE, INCLUDING CO-PAYMENTS,
UNLESS THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN SECTION
223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, IN WHICH CASE COVERAGE
FOR GENDER DYSPHORIA OR GENDER INCONGRUENCE MAY BE SUBJECT TO THE PLAN'S
ANNUAL DEDUCTIBLE.
§ 7. This act shall take effect immediately.